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tv   [untitled]    August 6, 2014 5:00pm-5:31pm PDT

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>> [gavel] the commission will please come to order and the second will call the roll. >> commissioner singer. >> present. >> commissioner taylor-mcghee. >> present. >> commissioner chow. >> present. >> commissioner sanchez. >> present. >> car da. commissioner karshmer. >> applicant. >> the -- present. >> the second item and i was on vacation and the minutes are an earlier version of the resolution you passed. the updated version should be in
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your pile so the minutes should reflect the final resolution. >> commissioners we're prepared for a motion to accept the minutes and with the fact that the final version of the resolution will be in the minutes. motion please. >> i move. >> there is a motion and a second already. are there any corrections to the minutes? >> i had a question. >> sure. >> on the request for follow up from human resources about progress on streamlining and making more effective hiring which seems to be a drag on progress in many of the departments in terms of meeting their objectives. when can we get that update? >> i believe the hr director will speak to you. >> director. >> good afternoon. we have a
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event in the last week of august and mapping it out and making improvements and i believe i asked to come back in september to give an update and i will check with mark to make sure i'm on the agenda. >> perfect. thank you. >> you're welcome. >> okay. any other comments or questions on the corrections? if not all in favor say aye. the minutes are approved. next item please. >> the next item is the director's report. >> good afternoon. i am sitting in for director garcia who is on a well deserved vacation in hawaii right now and the first is the launch of the san francisco health network, the sign is behind you and launched on july 30. simultaneous events took place at 28 sites around the city and staff celebrated the creation of
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the network and each other's contributions. i know rol an pickins is here and can talk about the launch last week. >> good afternoon commissioners. i am the director of the network. thank you. you will remember when i came to you in february and gave an overview of the development of the network i had slides on marketing and branding so this network launch was the fulfillment of the first part of the marketing and branding campaign which was an internal focus. we described we needed to do internal markets and branding before we went out to the public so this launch event was a culmination of the last months of an internal marketing and branding committee and
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chaired and co-chaired by staff and our chief communications officer so they had 30 staff throughout the department from community programs, laguna honda, san francisco general and actually did a great job developing the launch activity itself, a description of what the network is. there is information on all the different sites that the network consists of throughout the city, the various clinics so this was our internal launch and we will come back as we get ready for open enrollment in the fall for covered california and other health plans to do an external marketing communications program, but this was part one, and you will be be hearing more about part 2. i will be coming to the commission in september on an update on the network and we will talk more about communications and marketing.
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>> thank you. i am sure the commissioners would be happy to help also with our external approach to the public. >> okay. we will get your picture on the muni bus going by. okay. >> just a couple other items in the director's report related to open enrollment which mr. pickins referenced last thursday covered california and announced the rate for the exchange and the cost will go up by a weighted percentage of 4.2% and covered california region four which comprises the city and county of san francisco saw the largest weighted increase of 6.6%. the other changes in the regions were a reduction of 1% and those areas and increase of 6.3% in orange county. among the five health plans that will
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be available in san francisco and some blue cross has the largest weighted increase and those that stay with blue cross will have an increase of 10 to 14%. kaiser has the lowest weighted increase at one point 6% and those consumers will have a change of a reduction or a increase of 4% and blue child and health net and chinese community health plan also. finally the environmental -- supervisor cohen has introduced two measures at the board of supervisors to improve air quality in san francisco. one enhanced ventilation for sensitive use development is consistent with a resolution
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passed in 2013 by this commission commission and require ventilations for certain developments and multi-housing and others. clean construction is a companion measure to improve ventilation at sites to improve enhanced ventilation at construction sites that. concludes the director's report for today. >> commissioners any questions on the director's report? yes? >> colleen any -- what happened with covered california in terms of rate increases and where the providers for the city and county of san francisco came out relative to other places? anything remarkable about that or was that in line with what you guys expected? >>i think it's in line with what we expected. i think the overall increase state wide was reigning in costs and it's not seen as a large increase. i think there is a wide variety of
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costs with the providers in san francisco so there continues to be low cost plans available in san francisco. even though we have the highest rate of increase across all plans most plans ranged within the 4% margin, the next closest county was orange county at 6.3%. i think given our cost of living and other things here it's not unexpected that we landed where we did. >> when you cite the averages are they straight averages of bronze, silver and gold plans or averages of bronze? >> they're weighted averages and consider the increases in the plan and the commissioners in the marketplace. >> okay. >> on the exchange programs here in the city part of the real key would be what premium is at and some are very high and some very low. do the premiums
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come closer together for each of the plans because after all in the first year it was a guess on the part of everybody about where to go, so the real amount is -- of concern is whether the premiums had also come close to each other or are they still at a wide variation? >> i would have to look -- the levels vary by age and family size but i think it was expected. chinese community health plan for example came in very . the cost of the premiums were very low in the first year so they were the second highest rate increase among the plans in san francisco which was to be expected to level it out a little bit more. anthem was already a higher cost plan and the increase further -- >> further up, right. okay. and i guess are those now
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public? >> they are. >> can we have a copy of what you read out because that would be helpful. >> i will send my notes and the increases for the plan. >> okay. that would be very nice. thank you. any other questions? on the director's report though you didn't acknowledge -- in the sense the laguna honda survey came out very positively, did it? >> yes. i was just reading and trying to decide because it says that it had identified findings from two surveys, and you're waiting for a cdph so do we know that they did give us a clean bill of health or they didn't? >> through the chair if i might. >> sure. >> as we understood it through the committee it was brief in
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size but they were not going -- and we weren't going to make any absolute either congratulations or due diligence or shore up until we got the written report because there were a couple of surveys not completed, other dimensions, so that will be forthcoming. that's our understanding and from there we will proceed but at this point it looked like we weren't zapped with that and others but we were written for the actual report which will come within i think 45 days. >> okay. all right. if there are no other questions then we're prepared for the next item please. >> item four is the general public comment. i received no requests for general public comment. all right. shall we move on to the next item commissioners? all right. we will go on to the next item then. item five is the update from the finance and planning
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committee and commissioner singer chairs that today. >> commissioner. >> this was the first opportunity i had to chair anything. feel free to jump in and correct, amend, beat up my remarks here. so we met this afternoon for a few hours, and we heard very thoughtful presentation on sexual orientation guidelines and how to capture data, a theme we talked about in the last year, and you get a peek into the extraordinary thought of the staff and the department and how they go about thinking through things, and then we had a discussion about the icb9 contract delays. it's replacing icb10 -- sorry. ten is
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replacing icb9 and it is a very complicated thing to implement that has been delayed a number of times including recently. nevertheless we will have to -- the bad news we will continue to spend money this year getting ready for it even though it's delayed a year. that's the bad news. the good news if it wasn't delayed it would have been a crunch on the staff and there is revenue at risk as a result of that so one year is good for us and the ability to do this in a slightly more thorough pace is going to be beneficial to the city, and then we had the monthly contracts report. nothing remarkable about that, and then we talked about in-depth about three separate contracts, reasonably large, related to it infrastructure at sf general and in the city and i think the way
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to think about this is -- i am stealing someone's else analogy shamelessly but if you think of state of the art electron medical records and information systems for physicians and patients and nursing staff and everyone else in the ecosystem as cars you need a road to drive on before you can have a car so what these contracts related to basically is the infrastructure, the plumbing, if you will, of a network that meets all the codes which we're required to if you're a health institution which is much different than if you're a retail store for the obvious reasons, and so we heard -- we approved those contract and recommended them to be approved here which i guess we need to vote on in a second, but i think what was most encouraging for me was the
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depth of thought from the team at sfdph regarding how they're going to stage the investments and how to prepare for the future and how they talked about it so that was super encouraging. >> if i may elaborate. briefly the sexual orientation guidelines commissioners will come before you for approval for the second so you will have an opportunity to look at that and the contracts will be folded into an it presentation at the august 19 meeting so you can hear about those two. >> and do we need to vote on those formally today? >> in the consent calendar next item you voten mass for all of them. >> yes commissioner. >> yes. i was wondering if there is discussion on the siemens renewal. >> yes. >> and was there any conclusion
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pertaining to are -- we in fact -- i mean siemens has had a contract with the department for a number of years including certain different pathways that should have been done or done well, et cetera, et cetera and i am wondering if there are substantial discussions on what the outcomes have been and in particular i thought before we had a three, four year limit and when i looked at this initially there was a fairly long duration and i wonder if this was brought in the discussion. again i am not knocking siemens per se but we used to ask these questions and i am wondering -- >> some of the questions were asked and some weren't. to give context on the contract we're talking about and if bill is here -- >> unfortunately he's not here at the moment.
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>> let me try and anyone else can jump in. so we are moving in the general -- the new general hospital in about two years. in a perfect world we would have also used as an opportunity five years ago let's get a state of the art medical system in the san francisco general hospital then and it's unclear to me whether siemens would have been a candidate for being that vendor or not. i think it's up in the air but most talk about two other vendors when we ask them, but that decision wasn't made so we have the practical reality when we move into the san francisco general hospital we need to have electronic medical records and the reality is we just need to move the siemens system over there and that is what this contract is basically to do, and that is a non trivial exercise,
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but in addition we have struggled as a group here on the whole future of emr, rhr city wide for our work and we're beginning to see in these contracts thoughtful strategic investment to get ready for that. as we all know it's a very big number, but it's kind of table stakes for the new health care environment so we have to do it and as soon as we can. the joint commission talked about it when they surveyed the san francisco general hospital and made it absolutely clear in order to stay compliant et cetera, et cetera it's hard to think of a reason not to move quickly on this but regarding siemens' past performance on contracts we did not talk about that. >> no, no. again as i said when i sort of skimmed through and i apologize because of the
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amount of time and as i said in some of the early stages going way back for both our senior programs at laguna honda and at general it required a visit from their senior officers flying in from back east and europe to appear before the committee to answer questions that were generated because this was a significant amount of investment and we wanted to clarify and make sure that we all understood what in fact the parameters were and the projected outcomes and that and i am glad to see we're still carrying that out. >> director. >> if i may commissioners our information technology director mr. kim acknowledged exactly what you're saying commissioner and had called senior leadership of siemens into the room to have that discussion and is completely confident that a candid discussion will yield
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better results this time. thank you. >> thank you. >> and i would say while the numbers are fairly large in the contracts which we're recommending they are nothing compared to what we have to approve in the near future. >> and i think commissioner sanchez i could echo what commissioner singer was saying because we've all participated -- you and i in these same discussions and in this case our director has indicated that definitely this is a platform that's needed to be brought over and that siemens are the people to do it. and they can do it competently and that this was part of that roadway that we're building. it's necessary to move that all over at this point because there is no substitute that's a valuable by the time we move in, so i was personally satisfied.
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>> good. >> any other questions to our interim finance chair who did a great job. although you have chaired in the past a joint conference. i just want you to remember. >> strike that for the record. >> however, further questions on any of the contracts or we can move on to the next item. >> item six is the consent calendar. >> okay. in the consent calendar has on it our contracts report the three contracts that -- so we've already had a discussion. if somebody wants to eliminate again or i should say pull off of the consent calendar the calendars before us for voting and so all those in -- unless there is an extraction we will move on to vote. all those in favor say aye. >> aye.
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>> all those opposed. so the consent calendar has been adopted. >> thank you commissioners. item 7 is the health care service master plan consistency determination application review for healthright360. >> it's a mouthful. good afternoon commissioners. i am here before you to talk about the first consistency determination application under the health care services master plan which the commission endorsed in september of 2013, and the board of supervisors adopted -- sorry -- yes, 2013, and the board of supervisors adopted in december of 2013. so the ordinance was introduced in 2010 and became effective in 2011 and i should say since
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it's been a while since you had the health care services master plan in front of you i will give an overview of the process for your consistency determination and do an overview of healthright360's application. so the ordinance was passed in 2010 and effective in 2011. the purpose is listed here in quotes which is to provide the health commission, the planning commission and the board of supervisors with information and public policy recommendations to guide their decisions to promote the city's land use and policy goals developed in the plan such as distribution and access to health care services. as i mentioned it was endorsed by the health commission in september of 2013 and adopted by the board in december of 2013. the master plan really identifies current and future health care needs in san francisco and makes
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recommendations on how to achieve and maintain access to health care services. the commission may remember it was the as a result of a year long community engagement process which was the foundation for our community city bide health improvement plan. so it's intended to be a road map for bettering health and well being in san francisco and it takes a specific focus on access to care for particularly for san francisco's most vulnerable populations and geographic areas, low income folks and people with high health care disparities. the way the plan is structured it has quite a bit of information and then at the end it has recommendations and guidelines so there are nine recommendations, each with guidelines underneath them that are specific to each recommendation so the recommendations are listed here and they follow the community health improvement plan's three priorities. the commission may
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remember the plan prioritizes safe and healthy living environments, access to healthy eating and physical activity, and also quality access to health care services. of course since this is about where to place health care services in san francisco most of the recommendations fall under that third priority, and you can see here that 1.1 really addresses healthing living environments. 2.1 addressing eating and physical activity and the remainder talk about quality health care services so there is a focus on vulnerable populations, also promoting behavioral health access, ensuring the access of long-term care options for the aging population. make sure that we have the linguistic capacity to meet the needs of our population. access to transportation options for people in areas that are further from health care services. ensuring collaboration between
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existing health networks. making sure that we have sustainable information technology that increase access to health and wellness services. that we collect data on our residents and our patient population so we know what the health care -- the health needs of our population are and we promote the development of cost effective care. those summarize the nine recommendations that are part of the health care services master plan. so the health care services master plan really has two parts. it's sort of a road map for what our -- the current health care inventory and needs into the future and then it requires that projects that are being proposed in the city if they meet certain requirements they're compared against the master plan to determine whether they're consistent or not with the recommendations and the guidelines in the master plan so what you have before is a
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consistency application determination by healthright360 and so i'm going to go over a little bit about the projects and the process that follows. so projects that are subject to a consistency determination are those that are for medical use and i will define medical use in a second, that are more than 10,000 square feet so you're changing from some other use like a retail use to a medical use that is more than 10,000 square feet or expanding an existing use by 5,000 square feet and expanding a clinic there and adding another 5,000 square feet that is also subject to a determination and medical use is basically any place where services are offered by health care professionals that are licensed by a state board, so physicians, surgeons, dentists, et cetera. includes clinics
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providing out patient care and it also includes hospitals. there are three possible -- to the way that we structured the health care services master plan there are three possible outcome frs any project secretary to a consistency determination. >> >> the first it's consistent and recommended fortives. this means the projects that are qualified and on balance meet the recommendations in the master plan eligible for incentives and those eligible for incentives are those that at an actual facility by the correction of its project can seek to accomplish, so for example increasing information -- improving information technology. it's not necessary that a specific project build is going to increase information technology access but it might
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increase vulnerable populations so that's why it's eligible for incentives and others might not be eligible for incentives. the second outcome is just consistent so it's on balance, positively going to impact health care access in san francisco. doesn't necessarily meet any of the guidelines highlighted for instance or doesn't meet them to a sufficient extent and then finally they could be inconsistent. those that don't address any of the recommendations or guidelines in the master plan or adversely affect a service as needed in san francisco. and i should say -- i should have said in the last slide consistent and eligible for incentives means incentives in the planning process so in the entitlement process managed by the planning department and we have a representative here should you have any questions about incentives or the planning
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process. so the review process is as follows. applicant submit an application so healthright360 submitted to us an application for consistency determination. the planning department -- they submit to the planning department staff. planning looks at it and makes sure they meet the requirements for the project. do they meet the size threshold? are they changing medical use? if they do they forward that application to the health department and the third step in the process is the health department reviews the application and the accompanying justification to determine whether it is or isn't consistent with the master plan. when we brought the master plan to you for your review and endorsement you asked us to deal with the three different types of determinations in this way, so consistent applications, those that are plain consistent will be presented to the health commission as an infti